by Elizabeth Weise, USA TODAY

by Elizabeth Weise, USA TODAY

The worst of this year's flu season should be over in most of the country in two to three weeks except for the West Coast, where the flu arrived later, health officials said Friday.

"We're not at the end but we're nearing the end," said Michael Jhung, an epidemiologist at the Centers for Disease Control and Prevention.

He predicts two to three more weeks of higher flu activity nationwide, more in the West, and then perhaps four to six weeks of lower activity.

Flu season slammed into the East in late December, almost a month earlier than usual, according to the CDC. The major flu strain circulating in the United States this season, H3N2, also appears to be causing more severe illness, especially in the elderly.

This season, 50% of people hospitalized for influenza were over 65, Jhung said.

So far this season, 59 children have died as a result of the flu. Numbers for adults won't be available until the flu season ends.

"We're in the thick of it," said Oregon's Paul Cieslak, medical director of the state's immunization program. "Things are hopping here."

The state has had 18 confirmed influenza outbreaks in long-term care facilities just this month. "Holy cow!" said Cieslak when he counted them up. "We've been kind of going nuts here."

San Diego County announced 11 more flu deaths last week, bringing the county total to 30 so far this season, said Eric McDonald, a public health officer with the county.

"It's a moderately severe season and we're definitely right in the middle of it," he said. About 12% of visits to emergency rooms in the county are flu related, he said.

The death toll in San Diego is the second highest the county has ever had in a flu season. The highest was 58, during the H1N1 flu pandemic of 2009.

San Diego was where the first U.S. case of H1N1 flu was found at the very beginning of that outbreak and because of that the county has one of the best surveillance systems in the nation.

McDonald said he thinks the county's death rate might be higher only because officials are catching more flu-related deaths than other areas. "We're much better now at connecting the dots between someone who died of respiratory illness and influenza," he said.

The vast majority of deaths are in people who either are very old or have underlying medical conditions, McDonald said.

"In our 30 deaths, all but one of them had underlying medical conditions or advanced age," he said, adding the average age in deaths has been 78.That's very different from the 2009 epidemic when it was predominantly affecting younger people, he said.

In Washington state there have been 34 laboratory confirmed flu deaths as of Wednesday, up from 28 last week, said Washington Department of Health spokesman Donn Moyer. "Most of the death cases in Washington are in people 70 and older," he said.

One of the signals the CDC uses to indicate the official start of flu season is when more than 2.2% of all visits to the doctor nationwide are for flulike illnesses. In non-flu months, such as the summer, about 1% of doctor visits are for flulike illnesses. As of Feb. 2 the number of people visiting doctors and clinics for influenza-like illnesses reported in CDC's FluView report was 3.6%, down from 4.3% the week before.

Other signs that the flu is waning:

â?¢9.0% of deaths reported in the CDC's 122 Cities Mortality Reporting System were from pneumonia and influenza as of Feb. 2. That's well above the epidemic threshold of 7.2% but down from 9.4% a week earlier.